Inflammation within blood vessels (Vasculitis)

Vasculitis can affect blood vessels in different ways. Palpable purpura, which appears as small raised bruises, is a critical sign of small-vessel vasculitis, but other skin lesions may also occur. Vasculitis can cause a range of symptoms in various parts of the body that include:

• Red or purple spots on the skin
• Itching, lumps, or sores
• Headaches
• Fatigue
• Fever
• Weight loss
• Abdominal pain
• Pain and numbness in hands and feet
• Diarrhea
• Ulcers in the stomach
• Bleeding in stools
• Muscle weakness
• Confusion and difficulty focusing
• Dizziness
• Ringing in the ears or hearing loss
• Chronic sinus congestion
• Bleeding from the nose
• Red and itchy eyes
• Vision problems
• Difficulty breathing
• Coughing up blood
• High blood pressure
• Arrhythmia (irregular heartbeat)
• Angina (chest pain)
• Fluid retention or kidney failure

In serious cases, vasculitis can block blood vessels, preventing blood flow, or cause them to bulge (aneurysm) and possibly burst. These symptoms not only take a toll on the body but can also affect mental health. Make your mental health a priority with our wide range of mental wellness products to meet your needs.

The exact cause of vasculitis is not yet known. However, it is believed that vasculitis occurs when the immune system mistakenly attacks blood vessel cells as if they were foreign objects, classifying it as an autoimmune disease. Certain types of vasculitis may also be linked to a person's genetics.

Vasculitis is a rare autoimmune disease that can affect anyone. Some of the risk factors associated with vasculitis are:

1. Family history
Vasculitis runs in families, and the most common types include:

• Behçet’s disease
• IgA vasculitis
• Kawasaki disease

2. Lifestyle choices
Smoking can increase your risk of Buerger's disease, especially if you're a man younger than 45. Using drugs such as cocaine also raises your risk of developing vasculitis. It’s never too late to quit smoking. Try our wide range of smoking cessation products available to help you successfully overcome this deadly habit.

3. Medications
The risk of vasculitis increases if you take certain medicines like hydralazine, levamisole, propylthiouracil, and tumor necrosis factor inhibitors (used to treat some immune diseases).

4. Medical conditions
Disorders that can increase your chances of getting vasculitis include:

• Autoimmune disorders: People with disorders in which their immune systems mistakenly attack their body parts may be at higher risk of vasculitis. These disorders include lupus, Sjogren's syndrome, rheumatoid arthritis, and scleroderma.
• Cancer: Conditions such as lymphomas can increase the risk of vasculitis. Studies suggest that cutaneous vasculitis may be a manifestation of cancer.
• Infections: Having hepatitis B or C infections can increase your risk of vasculitis. Additionally, bacterial infections like gonorrhea may be associated with small-vessel vasculitis.

5. Sex
Depending on the type, the prevalence among men and women can vary. For example:

• Buerger’s disease: Most common in men.
• Giant cell arteritis: Affects women four times more often than men.
• Microscopic polyangiitis: Affects men slightly more often than women.

6. Race
Ethnicity can also increase your risk of vasculitis, such as:

• Behçet’s disease: Common in the Mediterranean, the Middle East, Central Asia, China, and Japan.
• Giant cell arteritis: Common in Scandinavia and Minnesota.
• Kawasaki disease: Common among Japanese children.

Did you know?
Systemic vasculitis can increase your complications if you are infected with the COVID-19 virus. Keep your guard up with our coronavirus prevention range.

Diagnosing vasculitis can be tricky as there are several types and the symptoms can overlap with those of other conditions. Your doctor will ask questions regarding your health and recent medication. They will also perform a physical exam and various tests to determine the type of vasculitis or rule out other conditions that resemble it. Diagnostic approaches include:

• Blood tests: Antibodies and certain types of blood cells can be signs of vasculitis. These blood tests include:
• Erythrocyte sedimentation rate (ESR) test: Helps determine whether inflammation is present.
• C-reactive protein (CRP) test: Checks for chronic disease or severe infection. A higher CRP value can indicate acute inflammation in the body.
• Antineutrophil cytoplasmic antibodies (ANCA): Determines whether ANCA is present in the bloodstream to check for autoimmune activity.
• Complement levels: Assesses bacterial or viral infection as the cause of vasculitis.
• IgE levels: Measures an antibody that the immune system produces to identify and eliminate harmful microorganisms.
• Hepatitis panel: Determines if a person has been infected with hepatitis A, B, or C viruses.
• Antiglomerular basement membrane (GBM) antibodies: Checks for kidney damage as a result of viral infection.
• Antinuclear antibody (ANA): Helps detect autoimmune diseases.
• Antiphospholipid antibodies (APL): Indicates the occurrence of Antiphospholipid syndrome (APS), an autoimmune disorder that causes abnormal blood clotting due to antibodies.
• HIV test: Rules out HIV infections in individuals presenting with symptoms of vasculitis.

• Urine dipstick and microscopic tests: A urine dipstick involves dipping a specially treated paper strip into a sample of your urine. This helps detect the presence of blood and protein in the urine, which are the first signs of small vessel vasculitis in the kidneys (inflamed kidney).

• Imaging tests: These tests can help evaluate and confirm which blood vessels and organs are affected. They include:
• X-ray
• Angiography
• Ultrasound scan
• Electrocardiogram (EKG)
• Electromyography (EMG)
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scan

• Biopsy: A minor surgical procedure in which a small piece of tissue is removed from the affected area of your body. Your doctor examines this tissue sample under a microscope for signs of vasculitis. This procedure is useful in evaluating types of small vessel and medium vessel vasculitis.

• Molecular imaging: This is a growing area of research that visualizes, characterizes, and quantifies processes in the body. This newer advancement in the imaging of vasculitis includes:
• Positron emission tomography: Measures function by looking at blood flow, metabolism, neurotransmitters, and drugs.
• PET scan: Used in the diagnosis of large vessel vasculitis.

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Vasculitis is an autoimmune disorder that cannot be prevented, but lifestyle changes and identifying the cause can reduce the risk and prevent flare-ups. They include:

• Quit smoking and tobacco: Tobacco use increases the likelihood of developing vasculitis by disrupting the immune system. Quitting smoking can be a highly effective way to protect yourself from this condition.
• Stay clear of drugs: Vasculitis is one of the common side effects of using illegal drugs. Refraining from such activities can lessen your chances to some extent.
• Lose some weight: Obesity can worsen the disease's progression. Engaging in low-intensity exercises for 20-30 minutes, such as walking, swimming, and yoga, can help with weight management and improve blood flow.
• Take vitamins and supplements: Supplements containing Vitamin D, Vitamin C, and antioxidants can reduce the risk of vasculitis.
• Choose a healthy diet: Eating foods rich in antioxidants can help fight infections. Increase your intake of foods high in vitamins and fiber, such as fruits, vegetables, nuts, seeds, whole grains, lean proteins, and low-fat dairy products, while limiting saturated fat. Switching to a healthy diet can prevent illnesses and minimize damage to the body.

The treatment of vasculitis depends on the type, location, and severity of the condition. The main objective is to decrease inflammation in the affected area and control any underlying factors that may be causing it. It includes:

Medicines

Medications are prescribed depending on the intensity of the symptoms and the progression of the disease. They include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): IgA vasculitis is typically treated conservatively with NSAIDs like aspirin.
• Immunomodulators: These are commonly used to sustain disease remission in the treatment of ANCA-associated vasculitis. The drugs used are:
  • Azathioprine
  • Cyclosporine
• Corticosteroids: Corticosteroids are used as first-line treatment and have anti-inflammatory properties. The drugs used are:
  • Prednisolone
  • Methylprednisolone
• Disease-modifying antirheumatic drugs (DMARDs): These are recommended only if corticosteroids do not work well or show major side effects. They include:
  • Rituximab
  • Cyclophosphamide
  • Azathioprine
  • Methotrexate
• Antimalarial drugs: Hydroxychloroquine has been successful in treating hypocomplementemic urticarial vasculitis (HUV) but not other types of small vessel vasculitis.
• Neutrophil-chemotaxis inhibitors: These are used in the initial treatments for Behçet's disease and similar disorders without systemic involvement. They include:
  • Dapsone
  • Colchicine
• Antiviral drugs: These are important in treating virus-associated cases of vasculitis. The most commonly used ones are:
  • Interferon α
  • Ribavirin
  • Vidarabine
  • Lamivudine
• Dual endothelin receptor antagonists: These block the action of a chemical called endothelin that can reduce blood flow.
• Interleukin antagonists: These reduce swelling by blocking a protein in the body that causes the swelling.
• Phosphodiesterase inhibitors: These drugs increase blood flow by blocking the action of a particular enzyme in the body.

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Intravenous Immunoglobulin G (IVIgG)

IVIgG is the preferred treatment for Kawasaki disease, as it helps prevent the development of aneurysms and improves various symptoms. Note: The medicines used in the treatment of vasculitis often have to be taken for a long time and can have side effects. It is important to talk to your doctor about your medicines and their side effects.

Surgery

Vasculitis can sometimes cause an abnormal bulging of blood vessels called an aneurysm, which can be treated with surgery to prevent bursting. In more severe cases, surgery may be needed to repair damaged blood vessels and organs or even transplant organs. Surgical procedures include:

• Plasmapheresis: This is done to reduce plasma antibody levels by removing and replacing blood plasma (liquid portion of blood).
• Bypass surgery: This may be helpful in restoring blood flow in certain areas affected by Buerger's disease.

Maintenance of Remission

Corticosteroids are tapered to zero or to the lowest dose that can maintain remission. IV rituximab may also be used to maintain remission, but the optimal dosage and infusion interval have not been clearly established. Individuals with frequent relapses may need to take immunosuppressants indefinitely.

Home remedies that can help alleviate the symptoms of vasculitis and its types include:

• Turmeric (Haldi): Studies suggest that turmeric, also known as curcumin, is helpful in managing autoimmune conditions due to its anti-inflammatory properties.
• Akarkara: Akarkara root or extract is generally used to manage pain and inflammation due to its antioxidant property.
• Garlic (Lahsun): It can be beneficial in the management of urticarial vasculitis due to its anti-inflammatory effect.
• Ashwagandha: It has antibacterial properties, which help fight and prevent infections.
• Holy basil (Tulsi): It has anti-inflammatory and antibacterial properties which can be beneficial for individuals with vasculitis.
• Apple cider vinegar: It can decrease digestive symptoms associated with vasculitis.

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If vasculitis goes undiagnosed for a long time, it can lead to serious complications. They include:

• Infections: Some prescribed medicines used to treat vasculitis may weaken your immune system, making you more prone to infections.
• Blood clots and aneurysms: Vasculitis can lead to blood clots that obstruct blood flow and may cause a blood vessel to weaken, resulting in an aneurysm.
• Vision loss or blindness: This is a complication of untreated giant cell arteritis.
• Stroke: The inflamed vessel wall can block oxygen flow to the brain, leading to loss of brain function and ultimately strokes.
• Organ damage: Some types of vasculitis can be severe, causing damage to major organs such as the kidneys, heart, lungs, and others.

Did you know that? Vasculitis is a potential complication of COVID-19, with certain types such as leukocytoclastic vasculitis (LCV), IgA vasculitis, and Kawasaki disease.

Complementary therapies along with comprehensive treatment can benefit individuals with vasculitis to manage their symptoms. These therapies include:

• Compression therapy: Studies suggest that compression therapy using short stretch bandages in vasculitic ulcers can improve healing time, relieve burning sensations, and reduce pain due to decreased inflammation of blood vessels.
• Chinese herbal medicine: Research has analyzed Chinese herbal medicine (CHM) for treating vasculitis, indicating that CHM can ease and reduce inflammation of blood vessels. It has shown excellent results in treating children with Kawasaki disease.
• Acupuncture: This therapy uses needles to lower levels of chemicals that cause inflammation in the body. It can help reduce pain and is beneficial for individuals with giant cell vasculitis.
• Homeopathy: This therapy can effectively treat vasculitis by targeting the root cause of the disease, which is an abnormal immune system. Selecting the appropriate constitutional homeopathic remedy can boost the immune system and alleviate vasculitis symptoms without adverse effects. However, it is crucial to seek medical advice before considering any alternative treatment.
• Yoga and meditation: Practicing yoga and meditation can increase energy and reduce chronic fatigue. These techniques involve deep breathing and positive visualization, which can reduce stress and anxiety while improving immune function by relaxing the body and mind. They also promote positive thinking and mental strength, which are important for combating serious illnesses.

Vasculitis can greatly affect a person's life and relationships, and can also impact their ability to work. Doctors focus on preventing organ damage and side effects, but it's important to remember that it's still possible to have a happy life with vasculitis. A few points that can help include:

• Give importance to follow-up care: If you experience any new symptoms or changes in your health, report to your doctor immediately. Regular health checkups can help monitor any side effects from the medication used to treat vasculitis.
• Get your vaccinations: Routine vaccinations protect you from infectious diseases such as pneumonia and flu. These can help prevent problems and complications that may arise from vasculitis treatment.
• Plan a safe pregnancy: If you had vasculitis as a child and plan to become pregnant, inform your healthcare provider. Vasculitis increases the risk of high blood pressure during pregnancy, so blood pressure should be closely monitored. Do not stop taking medication without consulting your doctor.
• Exercise regularly: Try to exercise more often, as it will help prevent fatigue and tiredness. Regular exercise can reduce high blood pressure, regulate blood flow, and prevent other health complications associated with vasculitis.
• Maintain a strong support system: Living with vasculitis can be tiring and difficult. It is vital to seek support from loved ones and connect with support groups for those with vasculitis, which can be recommended by a doctor.
• Avoid flare-ups: Following your doctor's advice and adopting a healthy lifestyle can help you manage flare-ups and prevent relapse.